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International Journal of Health Economics and Management

05.01.2024 | Research article

Education and reproductive health: evidence from schooling expansion in Turkey

verfasst von: Prabal K. De, Muhammed Tümay

Erschienen in: International Journal of Health Economics and Management

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Abstract

We investigate the role of additional years of schooling mandated by a compulsory schooling expansion law in affecting reproductive preferences and safe reproductive health behaviors in Turkey—a middle-to-high-income country with gender inequity in education but overall high levels of safe reproductive health practices at the time of passing the law. Using a fuzzy regression discontinuity design, we find that the additional schooling improved several health behaviors. However, the effects on some outcomes commonly analyzed in the existing literature, such as contraceptive use or fertility, were either weak or insignificant. Overall, our findings complement the current literature on the marginal health benefits of schooling expansion and suggest that policymakers consider the institutional and cultural factors while evaluating the scope and potential non-educational benefits of such expansions.

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Despite both the demand side (legal mandate) and supply side (physical and human capital investment in education) impetus, the compliance was not universal, as appendix Fig. 5 in the appendix shows. The proportion of students with 0–4 years of education (non-compliers before the CSL) remained the same for both treatment and control groups. However, the largest difference is seen at the junior high school level, showing that although the compliance was incomplete, the policy did have an impact at the intended level.

Appendix Tables 10 and 11 summarize some of the results from the existing literature, such as smoking (Cesur et al., 2014), age at first birth (Gunes, 2013; Dincer et al., 2014; Erten & Keskin, 2020); and birth size (Gunes, 2015) and knowledge of the ovulation cycle (Dincer et al., 2014) updated with the 2013 TDHS data whenever applicable. Most of the results are consistent with the previous literature. Two exceptions are the negative impact on deficient birth weight found by Gunes (2015), which we do not find. However, the significance was at only a 10% level. We also do not find any significant impact on the knowledge of the ovulation cycle.

Although another round of TDHS was conducted in 2018, the data were not available as the time of writing the draft.

One concern that is largely ignored by the current literature is that since the CSL97 had increased the level of education of women, it might also have affected the marriage decisions. Which, in turn may affect the pool of ever-married women of which the DHS sample has been drawn. However, we have not found any conclusive evidence of DHS sample being biased. The survey was a joint effort by Hacettepe University Institute of Population Studies and T.R. Ministry of Development and has been used in numerous studies.

Admittedly, the CSL97 changed both men and women’s schooling. Since our sample consists of ever-married women, husband’s education may also affect the outcome variables. We have tried to address this issue by controlling for husband’s education and by providing the reduced-form estimates (the direct effect of the policy on outcomes).

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Titel: Education and reproductive health: evidence from schooling expansion in Turkey
verfasst von: Prabal K. De
Muhammed Tümay
Publikationsdatum: 05.01.2024
Verlag: Springer US
Erschienen in: International Journal of Health Economics and Management
Print ISSN: 2199-9023
Elektronische ISSN: 2199-9031
DOI: https://doi.org/10.1007/s10754-023-09364-x

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